Dental expressly covered · Last verified 2026-08-29
Ind. Code §27-8-5.7-6; §27-13-36.2-4
Under Ind. Code §27-8-5.7-6; §27-13-36.2-4, the Indiana payment deadline is 30 days (electronic) and 45 days (paper). Interest accrues from day 31 (electronic) or day 46 (paper) until payment, at the same rate used for Medicaid late payments: the prior fiscal year's average state general-fund investment yield, rounded to a whole percent — roughly 1% in recent Department of Insurance bulletins, not the flat figures often quoted. Dental applicability: Covered on both tracks. Self-funded (ERISA) plans are outside this statute — federal ERISA deadlines apply to them instead.
Clean claims must be paid or denied within 30 days when filed electronically and 45 days on paper — identical for insurers (IC 27-8-5.7-6) and HMOs (IC 27-13-36.2-4). Deficiency notices must go out within the same windows, and a payer that fails to send one establishes the submitted claim as clean.
Interest accrues from day 31 (electronic) or day 46 (paper) until payment, at the same rate used for Medicaid late payments: the prior fiscal year's average state general-fund investment yield, rounded to a whole percent — roughly 1% in recent Department of Insurance bulletins, not the flat figures often quoted. The real teeth are the compliance penalties: an insurer paying under 95% of clean claims on time in a year faces up to $10,000; under 85%, $10,000–$100,000; under 60%, $100,000–$200,000.
Covered on both tracks. The insurer chapter's definition of provider expressly includes dental services, and the statute names the ADA claim form as a permitted format. Dental-only HMOs are covered as limited service health maintenance organizations — "limited health services" starts with dental care services in the statute's own list.
Self-funded (ERISA) plans: Self-funded employer (ERISA) dental plans are outside every state prompt-pay statute — federal law preempts state insurance regulation of self-funded plans. Those claims run on the federal ERISA claims-procedure deadlines instead: a post-service benefit determination within 30 days (one 15-day extension), at least 180 days to appeal, and an appeal decision within 60 days (or two 30-day levels), under 29 CFR 2560.503-1.
Uses the verified Indiana rule (Ind. Code §27-8-5.7-6; §27-13-36.2-4). Estimate only — the statute's own accrual triggers control.
Estimated interest
$1.05
1% per year (recently published rate — confirm the current bulletin)
Indiana's rate is not fixed: it equals the average investment yield on state general-fund money for the previous fiscal year, rounded to the nearest whole percent (IC 12-15-21-3(7)(A)). The Department of Insurance announces it by bulletin — recent bulletins set it at 1% per year. Enter the current published rate before relying on an estimate.
Formula: claim × published annual rate × days late ÷ 365, using simple (not compounded) interest as the statute states it. The rate and deadline come from Ind. Code §27-8-5.7-6; §27-13-36.2-4, verified against the statute text linked in the sources on this page (last verified 2026-08-29). Accrual start dates, clean-claim status, safe harbors, and plan funding all affect the real figure — treat this as an estimate for the payer conversation, not a demandable amount.
